Low awareness of maternal healthcare exposes children and women to high risk

11 February 2009 Dhaka. Lack of awareness about antenatal, delivery and postnatal care are predominant factors that put mothers and children’s lives at risk, according to a recent survey on maternal and neonatal health conducted among more than 13,000 women in four districts, Narial, Jamalpur, Thakurgaon and Moulovibazar.

For about 62% of the women interviewed antenatal care or delivering at the health facility ‘was not seen as necessary’ or ‘beneficial’. For one in four women, the issue was the lack of money. About 10% felt that they would receive better delivery care at home compared to health facility.

Nor surprisingly, only 15% of these women reported having delivered their last baby in a health facility and the figure was as low as 6% among the poorest group. The percentage of those receiving antenatal care was much lower among the poorest with only 23 % of the poorest women getting antenatal care. Similarly, only 10 % of the poorest women reported being assisted by trained health service providers during delivery, against 41% among the wealthiest.

The findings of the survey were disclosed at a dissemination session organized jointly by Ministry of Health and Family Welfare, UNFPA, UNICEF and WHO at IDB Bhaban in Dhaka. The meeting was attended by Prof. Shah Monir Hossain, Director General of Health Services as Chief Guest while Dr A.B.M. Jahangir Alam, Director, Primary Health Care chaired the session. The survey was conducted in March 2008 and completed in November 2008 under the Joint GOB-UN MNH Initiative “Accelerating Progress towards Maternal and Neonatal Mortality and Morbidity” implemented by Ministry of Health and Family welfare with the technical assistance from the three UN agencies.

The survey also highlights that women are not the key-decision makers in matters relating to the delivery and postanatal care. Only 14% of women seeking treatment for complications reported making the decision themselves. For 78% the decision to seek treatment was taken by their husband and for 21% for the parents-in-law.

Early marriage, teenage pregnancy and early child bearing were identified as major causes of increased vulnerability for women and new born lives living in those four districts. The average age of marriage for the women interviewed was 16 years old and 72 % became mother for the first time before age 20. The figure was 79% in Jamalpur district.

Although women were generally satisfied about the quality of services they received at health facilities, 15 % reported that they had to wait for more than 45 minutes to receive treatment for complications.

These findings are important to inform policy makers and health and family planning teams what is needed to reduce maternal and neonatal mortality. Key recommendations based on the survey are: improving access to skilled birth attendance, creating awareness on the importance of safe delivery by skilled service provider and encouraging women to use health services through an increased support from family and community; providing information about family planning and optimal birth spacing.